Thursday, January 18, 2007

Cost of MD

As I look at the HSDN forum I see so many bright eyed idealistic premeds. How many of you have thought about the costs associated with medicine. Some are easy to quantify monetarily direct costs are 4 years of foregone income after college. That works out to $200,000. There are the additional costs of medical school an instate schools will be 20,000 per year, OOS or private will easily be 40,000 per year. Living costs are 15,000 per year for bare bones in a low cost area, higher cost areas like New York can easily top 25,000. The average medical student graduates with $150,000 of debt from med school on top of whatever costs you have from undergraduate assuming average debt from undergrad that's an additional $20-40,000 with the interest clock running. In addition you will be paid horribly for the 3 to 7 plus years of residency and fellowship. This is merely the economic cost. There are huge intangible costs to attending medical school or any other professional school. In college you will study harder than most to maintain the 3.45 average for Osteopathic or 3.65 for allopathic medical school. While your best friends party, you will study. You will do research and ECs that may be tangential to medicine merely because they are expected not out of any abiding love or desire to do them. You will be forced to take a proscribed set of courses. Once all of this is done you sit for the MCAT, a difficult exam requiring months worth of preparation, a low score may mean 3 years of hard work were all for nought. After all this you apply you have a 50:50 shot of getting accepted anywhere. If accepted you will complete 2 years of basic sciences, you will study all day and night. You then sit for the COMLEX or USMLE which will help determine what caliber of specialty you will match into. Then come clinicals, long days and pimping questions characterize this time. You then do the match and find out what you will spend the next 3-7 years doing in residency. Residency involves long days and nights, lack of sleep and horrible pay. If you do a fellowship you will be paid even worse during this. 11 to 15 years after your high school diploma you will finally practice. Starting pay is not wonderful PCPs may start as low as 75K specialists in the mid 200s. You will have had to delay marriage and starting a family most likely. Pay in real terms is falling. Medicare continues to cut pay in both real and relative terms. PCPs are making 150K 20 years out of medical school, not bad, however with your exceptional debt load and taxes you won't see most of it. Preexisting relationships will be strained throughout medical school and many will fail.

The point of this is not to dissuade you from going for your MD or DO, but to give pause. Contemplate how committed you are. From a financial perspective avoid as much undergrad debt as possible and eschew expensive private med schools for cheaper state schools. If you will be graduating with 300K in debt you will be forced into choosing the best paying specialty. Medical school costs have really been hiked up when my father went to med school in the mid 70s the cost was 20k or in todays dollars $80,000 and this was at one of the most expensive private schools in the US. Today it is 172K for four years not including the additional 25 or 30K in living costs a year. With the coming changes and continued cutting of reimbursement consider this. Also consider the cost emotionally being a physician is disruptive, you will get called and paged at all hours. Think about this carefully. Medicine is no longer accesible to the poor and is quickly outstripping the ability for the middle class to pay for. Even if you take out loans they will cost you 2200 a month assuming 10 years at 6% interest. However this is artificially low. You will most likely be forced to defer payment through residency and the interest will continue to roll on.

Wednesday, January 17, 2007

Examkrackers

1) Your individual scores and composite score

Total: 39R
PS: 13
BS: 13
VR: 13
WS: R

2) The study method used for each section

A) SELF STUDY AND WORK FROM THE EXAMKRACKER BOOKS. I actually signed up for the Examkrackers course (www.examkrackers.com) at Columbia University. The course was taught by Jon Orsay (one of the founders of the company and the main writer of the book). He is a phenomenal teacher, but his lecture style was EXTREMELY similar to his books. In the interest of time, I ended up skipping the classes while still following their schedule and just studying on my own.

B) READ EACH CHAPTER TWICE. The chapters in the Examkracker books are pretty short and manageable. However, each chapter is content filled and emphasizes a conceptual understanding of the material (as opposed to rote memorization of formulas). I would suggest reading each chapter AT LEAST twice. In contrast, I found the Kaplan books to emphasize rote memorization which I'm not a big fan of. In addition, since the MCATs emphasize conceptual understanding and not rote memorization, I thought that the Examkracker books were a bit superior in that regard to the Kaplan books.

C) MAKE A STUDY SHEET AFTER EACH CHAPTER. After each chapter, I would make a little study sheet that contained pertinent formulas and conceptually difficult concepts for that chapter. My study sheets for Biology, however, were pretty long since Biology is less quantitative.

D) DO DRILLS FOR DIFFICULT SCIENCE TOPICS. If there were specific topics (e.g. fluids, or acids and bases) that were still unclear to me after reading a chapter in the Examkracker books, I did drills on those topics with the Examkrackers 1001 Questions books. (Some of my friends tried to go through all of the questions in the 1001 Question books, which I found to be a big waste of time. Why study a topic that you have already mastered any more than you need to?)

E) SKIP THE MINIMCAT BOOKS THAT EXAMKRACKER PROVIDES. Don't bother doing the questions in the MiniMCAT books that Examkracker provides. I personally found that those questions were not representative of the level of difficulty of real MCAT questions (I thought that they were too hard), nor phrased in the way an MCAT question would be asked.

F) USE PRINCETON REVIEW TO STUDY THE TOPIC OF OPTICS. I also thought that the lecture on Optics in the Examkracker Physics book sucked. It emphasized rote memorization and employed confusing mnemonics (quite a contrast from the rest of the books). If I remember correctly, it's the last chapter in the Physics book. Use Princeton Review to study Optics. I found their explanation of that topic to be clear and comprehensible.

G) DONT DO EXAMKRACKER PRACTICE TESTS. DO THE AAMC PRACTICE TESTS INSTEAD. I thought that taking the exams under similar testing conditions as the real MCATs was important. I also heard that the Examkrackers practice tests were pretty hard and not representative of the real MCATs, so I ended up bringing my own AAMC tests to their practice exams and used Examkracker's bubble sheets. (The Examkracker people won't mind at all).

H) GET ONLINE SUBSCRIPTION TO ALL AAMC TESTS. Buy an online subscription to all of the AAMC tests (www.aamc.org) from the AAMC. It's a bit on the pricey side (of about ~$200 if I remember correctly), but it's an investment that will pay off dividends. I would plug in my answers from my bubble sheet and see which ones I got right. You can view the explanations of the questions online which I found EXTREMELY helpful.

I) FINISH ALL MATERIAL A WEEK BEFORE THE REAL MCAT. If you follow the Examkrackers schedule, you should finish everything a week ahead of of the test. During that week, I simply reviewed my study sheets and the concepts of the wrong answers from my AAMC tests.

J) PRIORITIZE THE EK STUDY BOOKS OVER EK'S AUDIO OSMOSIS CD. The Audio Osmosis is a severely diluted version of the Examkracker Books. In comparing the CD to the Study Books, Audio Osmosis does not have the practice problems, lacks a lot of the conceptual examples (that really cement the concepts in your head), and lacks the practice quizzes that are all found in the books. In fact, I stopped listening to Audio Osmosis after a few lectures after realizing these things.

K) If you have any other questions, feel free to PM me and best of luck with the studying.

3) What materials you used for each section(Kaplan, TPR, Examkrackers, AAMC, etc)

Examkrackers

4) Which practice tests did you use?

AAMC: 3R, 4R, 5R, 6R, and 7 (I think that they also have 8 out now)
If you have time, do practice tests from the other companies, but DEFINITELY PRIORITIZE THE AAMC ONES SINCE THEY WILL MOST CLOSELY RESEMBLE THE REAL MCAT.

5) What was your undergraduate major?

Psychology and English Literature -- There is hope for us humanities majors.

6) Any other tips you may have for those of us who still have this test lurking over us?

*** The week before the test, simply review your study sheets along with the explanations of the wrong answers that you got on your AAMC tests. Trying to cram in new material, and finding that it was not sinking in would probably stress me out before the trest.

*** Eat a big pasta dinner on the Thursday night before the test. Jon Orsay mentioned that glycogen storages are at their peak two days after consumption.

*** If you are like me and have difficulty falling asleep before important events like this, get a prescription for a sleeping pill (e.g. Sonata or Ambien) from a psychiatrist and take it the night before. CAUTION: Be sure to test out the sleeping pill well beforehand to see if gives you any side effects like drowsiness the day after. For example, Ambien works well for me, but leaves some of my friends feeling drowsy the day after.

*** Bring a digital watch to the test. If you start the stopwatch and you're worried about nasty looks that the proctors may give you when your watch beeps, hold the watch under your thigh to mute the sound.

*** In the beginning, I had difficulty with timing. To correct this, I started timing 9 minutes to complete a verbal passage and all of its questions. For the physical science and biological science section, I would plan for "ROUGHLY" 19 questions every 25 minutes.

*** Bring Gatorage and PowerBars to the testing site. All testing sites are different, but some testing sites will allow you to hydrate during the test while others won't. Thankfully, mine did (to the AAMC's chagrin). I would snack on half a PowerBar between sections for extra boosts of energy. Also, pack your own lunch to the MCATs. God forbid you're stuck with one Deli around your testing site, and everyone rushes there talking about which question they missed and you'll have to stand in this ginormous line for food and not have enough time to eat it.

7) How long did you study for the MCAT?


2) The study method used for each section

I just pmd someone an answer to what my study strategy was, and I'll just paste that here. It's really long, so watch out.

Sorry it took me so long to get back to you, but here are some tips.

I didn't take a regular MCAT course, but I did use Kaplan's online course, as well as the examkrackers CDs. I went through almost all of the old MCAT exams, and I found them to be much more usefull than the Kaplan practice tests.

There were a couple of key points to my preparation.

a) Hitting the content from multiple different angles. I would read through the Kaplan review section, watch the lesson online, listen to the CDs, and review my old textbooks.

b) Preparing with cycles of review. I didn't study straight from December to August. Rather, I studied for several intense periods of ~3 wks, and then let it be for a few weeks. My final cycle was 6-7 weeks straight, and I dropped everything else I was doing about 2 weeks before the exam so I could devote all my time to the final preparation. I tried to cover as many topics as possible each cycle, and then re-review the next time through. This way I was able to really solidify the information. I went into more detail in December for the areas I felt less comfortalbe with (ie, physiology).

c) Practice. I used the MCAT q-bank to test myself with MCAT style questions after reviewing each topic from day 1. I started taking full length practice exams about 6-7 weeks before the exam.

d) Re-evaluation. After each end of review minitest or full length practice exam, I would look at each question I missed, and try to understand what went wrong. Sometimes it was a strategy issue (eg, i misread the question), sometimes it was a content issue (say I didn't understand a particular concept). I kept a record of each of these reasons for missed questions, analyzed why they happened and how to not miss a similar question the next time. When I started to see patterns I would jot them down in a master notebook with some trouble-shooting ideas. I reviewed this master notebook regularly, and went through the few key points early in the morning on test day.

e) Pacing is not about pushing yourself to go faster, it's about making the answers automatic. I got to the point where I could get all the physical science questions right if I was able to take more time, but became frustrated because then I couldn't finish all the questions. When I tried to increase my pace, I would get a lot of questions wrong. Finally I realized that pacing wasn't about going faster, but about having the forumulas and basic approaches to problems down cold. I started reviewing all of the Kaplan PS flashcards that weren't automatic answers (about 70%) right before I would take a practice test. When I started that process, I began getting 14 or 15 on PS every time. I woke up really early on test day to get through all of the flashcards after I reviewed the key themes from my "how not to miss this kind of question again" master notebook. I went through the relevant orgo flashcards (about 50%) and biology flashcards (about 20%) first, and then the PS flashcards -- because PS is first on test day.

I never figured out my pacing problem for verbal, and kind of blew it on test day. I ended up just filling in the C bubble for the last set of verbal questions on test day (5-7 questions?) because I ran out of time.

I think the key to my performance was developing a personal approach by analyzing MCAT style questions I had missed. If you can pick apart the reasons for choosing the wrong answer for practice exams, you can do this.

Good luck!


OK. I took the MCAT 2 years ago and was scoring 7's on my verbal practice MCATS until someone told me this strategy and I scored a 9 on verbal to bring my total MCAT score to 31. Here it is. The problem with verbal is that you don't have enough time to finish the essays most of the time. Firstly, you should have already practiced enough to time your sections to an exact science. Then use this strategy to get you ahead of everyone else: Read the first paragraph of the essay only and scan the questions for questions on that paragraph (on the real MCAT they are out of order). Answer those questions first. Then read the second paragraph and scan the questions for questions on that pragraph. Repeat this procedure until you finish the essay. Note: combine really short pragraphs so you don't do more that 4 steps of reading. You will be left with either no questions or one or two evaluative questions on the whole essay. Answer these last. This tecnique saves you the time of looking back trying to find the location of the material in the essays and the material is fresh in your head so you don't have to reread a lot. I'm telling you, forget what Kaplan tells you and try this strategy. It got me 2 extra points.
yanky5 is offline


Originally Posted by nir1009
I used this strategy on Examkrackers 101 passages Test 7. Got a 10 (but just barely -- 45 Raw Score). I was getting a 44-45 raw score before also, so I don't know how much it helps. But I felt MUCH better about all of my answers and less pressed for time. Its worth a try. Thanks for the strategy!
No problem. I am not joking about the strategy. It really worked for me. You guys should try it a few times and see if it works for you too. When I took the MCAT 2 years ago, I went up 2 points from most of my practices after only trying it a few times. The problem I was having is not that I didn't have confidence in my answers, but I was pressed for time and always barely finished verbal before the time limit or didn't finish it. So, I would always rush the last 2 passages for time reasons. This strategy allowed me to finish the MCAT verbal with time to spare so I was doing better. You'll see that most of the time you waste on verbal is from trying to search the passage for material, but if you read one paragraph at a time, the material is in your short term memory, and if you forget it, there is only one paragraph to search so you save time. There is only a few holistic questions usually so you save these for last (unless the MCAT changed in 2 yrs, but I doubt it). Don't forget that on the real MCAT the questions are not in order, so you must quickly scan the questions for questions on your paragraph.
yanky5